血友病患者に生じた舌癌の1例 A case of cancer of the tongue in a patient with hemophilia A
Since the development of replacement therapy with factor VIII and factor IX for the treatment of hemophilia, various operations have been performed in patients with hemophilia. However, there have been few reports of neck dissection in patients with hemophilia when surgery was unavoidable. We present a case of cancer of the tongue in a patient with hemophilia A. A 63-year-old man had been given a diagnosis of hemophilia A as a child. He was admitted to the hospital because of contact pain at the right edge of his tongue, and histopathological examination confirmed squamous cell carcinoma. Blood coagulation studies showed a normal activated partial thromboplastin time (APTT)(37.4s, normal range 25-41%). Bleeding time was within normal limits, and the factor VIII level was 17%. A diagnosis of cancer of the tongue was made, and partial excision of the tongue was carried out. To maintain factor VIII levels above 40%, factor VIII concentrate was administered from the day of surgery onward. Slight hemorrhage from the surgical wound was observed at the 17th postoperative day, and replacement therapy with factor VIII concentrate was therefore continued. Seven months after the operation, metastasis in a right submandibular lymph node was found on computed tomography. We carried out a radical neck dissection. To maintain factor VIII levels above 50%, factor VIII concentrate was administered from the day of surgery, and no hemorrhagic complications were observed.
日本口腔外科学会雑誌 51(11), 563-566, 2005-11-20
Japanese Society of Oral and Maxillofacial Surgeons